Conflict in Somalia: impact on child undernutrition

Kinyoki, Damaris, Noor, Abdisalan, Uthman, Olalekan, Kandala, Ngianga-Bakwin, Odundo, Elijah, Moloney, Grainne and Berkley, James (2017) Conflict in Somalia: impact on child undernutrition. BMJ Global Health, 2 (2). e000262. ISSN 2059-7908

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Abstract

Background: In Somalia, protracted conflict and persistent drought have caused population displacement and livelihood destruction. As a result, there is widespread child malnutrition. We aimed to determine the effects of conflict on wasting and stunting among children aged 6-59 months in Somalia 2007–2010.

Methods: Data were from household nutritional surveys from 2007 to 2010, with 1,066 clusters covering 73,778 children, the Armed Conflict Location and Event Data (ACLED) project and remote sensing. We used Bayesian hierarchical spatial-temporal regression methods to examine the effects of conflict on wasting and stunting. A preliminary model included individual, household and environmental covariates without conflict. The main model included recent (<3 months) and longer term (3-12 months) conflict events.

Results: Conflict events were associated with malnutrition independently of individual, household and environmental factors. Whilst recent conflict was associated with wasting odds ratio (OR) = 1.21, 95% credible interval (CrI): (1.15, 1.28) and stunting (OR=1.37, 95% CrI = (1.33, 1.42), effect sizes were greater for long term conflict on wasting (OR=1.88, 95% CrI = (1.83, 1.94) and stunting (OR=1.76, 95% CrI = (1.71, 1.81). After controlling for conflict, the risk of malnutrition among the internally displaced person (IDP) increasedfor wasting (OR=1.62, 95% CrI: 1.54, 1.70) and stunting (OR=2.23, 95% CrI: 2.07, 2.40) respectively. In addition, the effect of vegetation cover on the low risk of stunting (OR=0.40, 95% CrI: 0.39, 0.41).

Conclusion: Short and long term conflict are independently associated with both wasting and stunting even after controlling for the effect of all other individual, household and environmental factors, including drought. The presence of conflict events may induce a long-term physical adverse effect on child health.

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